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Toronto Star: He was refused a study permit extension because he’s HIV positive. Now he’s challenging Canada’s medical inadmissibility rules

Nicholas Keung June 3, 2024



All his life, he has lived in fear of being judged and disowned by his family and friends because he’s attracted to men.


That’s why he was excited to be accepted by a college in Toronto and he applied for a study permit; it would give him a way to start a new life far from the Philippines, and be out of closet.


But he was devastated when his medical exam uncovered that he’s HIV positive, which could jeopardize his plan.


His prognosis was excellent with proper medication and he was able to get the clearance to study in Canada.


After graduating last summer from a one-year program in caring for people with developmental issues, he applied for further studies. However, his study permit extension was refused on the grounds that his health condition might cause an excessive demand on Canada’s health or social services.


That refusal has made him doubt whether Canada is as accepting as he thought — and has become the focus of a court case on behalf of migrants facing medical inadmissibility on health grounds.


“Is Canada really an open country or is it just a pretension?” asks the 29-year-old man, who has launched a Charter challenge of the excessive-demand provision of the immigration law. Under a court order to protect his privacy, he can only be identified as R.A.


The excessive-demand provision of the law is meant to ban people with disabilities and excessive health needs from coming to Canada, to prevent strain on health and social services systems. The provision has been criticized by advocates as discriminatory.


Historically, applicants with HIV and conditions like autism and intellectual disabilities make up most of the medical inadmissibility cases.


In 2017, a parliamentary committee recommended that Ottawa repeal the law after its study found the clause goes against the United Nations Convention on the Rights of Persons with Disabilities and is out of touch with Canadian values.



Although there have been fewer medical inadmissibility cases since then, Anne-Rachelle Boulanger of the HIV Legal Network said the provision still fosters discriminatory attitudes and hence, the organization is joining the legal challenge in support of R.A., calling for its repeal.


“For us, it’s really about finally having our immigration laws not perpetuate or reflect stigmatizing and discriminatory views of people living with disabilities, including HIV, as well as people who don’t have citizenship,” she explained.


In the current case, Boulanger said the Immigration Department was aware of R.A.‘s HIV status when it issued its initial study permit. She said it only refused the extension at the discretion of another officer, with no analysis of the alleged excessive demand caused by the applicant’s medical status and needs.


“It was pretty shocking that he was accepted the first time and his medical condition didn’t change at all,” she said, “yet when he applied for an extension, all of a sudden, now he is an excessive demand.


“There have been huge advances in terms of the health care of people living with HIV. It’s no longer a death sentence. People with HIV live long and healthy lives as long as they can access the necessary treatments.”


R.A., a pharmacist back home, who is not out to his family and friends about his sexuality and HIV status, said his health has been under control with medication and he doesn’t pose risks to anyone.


Like other international students, he needs to buy private health insurance. His HIV medication is paid for by the company that manufactures it through a community clinic that offers health care and supports to people living with the virus.


Although the Philippines is a democracy, R.A. said it’s also a very closed and religious society, where LGBTQ people are tolerated but not accepted.


“HIV is a taboo topic in the Philippines. There’s still stigma,” said R.A., whose study permit expired last August. He’s in Canada on a visitor visa that’s valid through September.


People with HIV are often seen as morally blameworthy, sexually irresponsible, dirty and unwelcome, he said, adding that they face discrimination at work, in relationships and in housing. Some health-care providers refuse to provide treatment, he added.


“This is not only my fight,” said R.A., who has been accepted by a postgraduate pharmacy technician diploma program in Alberta but needs a study permit. “It’s a battle for all people living with HIV who want to come to Canada.”


Citing the 2017 parliamentary committee report, his lawyer, Mathew Wilton, said the excessive-demand provision results in savings of only 0.1 per cent of all provincial and territorial health spending.


Wilton argued that his client was not provided an opportunity to address any concern from the immigration officer refusing his study permit extension and the decision was unreasonable and not supported by evidence.


“By viewing people solely as potential burdens or impediments, it ignores the reality that people with disabilities, including those without permanent residence or citizenship, make important non-economic and economic contributions to Canadian society,” said Wilton.


“It perpetuates negative stereotypes toward immigrant communities that they are simply here to abuse and take advantage of our public resources.”


In an email, the Immigration Department said it can’t speak about litigation that’s before the court, but stressed it has taken steps to bring the law in line with Canada’s values on diversity and inclusiveness, as well as the recognition of newcomers’ contribution to the country.


It said the 2018 updates to the excessive-demand rules strike the right balance between welcoming newcomers and reducing stigma while protecting publicly funded health and social services.


“As a result of these changes, many applicants, particularly those with conditions that primarily require publicly funded prescription drugs, would likely be admissible,” the department said. “HIV infection alone does not automatically make a person inadmissible to Canada on health grounds.”

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